Delayed skin discoloration spreading in the direction of gravity after injection of hyaluronic acid dermal fillers in both nasolabial folds

Abstract

Hyaluronic acid (HA) is the most commonly used filler biomaterial worldwide because of its safety, longevity, lack of immunogenicity, and biodegradability. In addition, HA is not specific to any organ or species, and there is a relatively low risk of an allergic or immunogenic reaction at the injection site. On the other hand, skin discoloration after a HA filler injection can increase for three reasons, including the Tyndall effect, neovascularization, and hyperpigmentation. This paper presents a case of skin discoloration after an injection of HA filler in the nasolabial fold with an unusual progress pattern.